Reconstruction of Disruptions of the Deep Transverse Metacarpal Ligament of the Ring Finger Using the A1 Pulleys

Josty, Ian C.; Laing, Hamish; Dent, Chris

doi:10.1016/j.jhsb.2006.04.017

Cited by 6 publications

(9 citation statements)

References 5 publications

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“…In traumatic cases in adults, the A1 pulley is usually used to reconstruct deficiencies of the DTML. 4 As the hand grows, there is a possibility that the gap between the two metacarpals may widen and instability to occur. We also felt that the A1 pulley was too small to reconstruct the DTML, that is why we used a technique similar to that reported by Lee et al 5 in the treatment of a neglected rupture of the deep transverse metacarpal ligament in an adult.…”

Section: Discussionmentioning

confidence: 99%

Lipoblastoma of the Hand Treated With Excision and Ligament Reconstruction: A Case Report

Estrella

Lee

2008

Hand Surg.

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Lipoblastoma of the hand is a rare benign tumour of infancy. Although benign, the tumour can present as a large mass. We present a case of a two-year-old female with a large, slowly growing soft tissue mass between the second and third metacarpal of the right hand. After excision of the mass, the deep transverse metacarpal ligament (DTML) was reconstructed using a free tendon graft from the extensor indicis propius (EIP).

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Section: Discussionmentioning

confidence: 99%

Lipoblastoma of the Hand Treated With Excision and Ligament Reconstruction: A Case Report

Estrella

Lee

2008

Hand Surg.

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“…The deep transverse metacarpal ligament (DTML) is a structure that extends between the head of the second to fifth metacarpal to maintain the stability of the transverse metacarpal arch. [1][2][3] Injuries of this ligament due to blunt trauma produce DTML injury and present with pain, decreased grip strength, deflection and diastasis of the affected fingers. 2,4 Several surgical techniques for its reconstruction have been described.…”

Section: Introductionmentioning

confidence: 99%

“…2,4 Several surgical techniques for its reconstruction have been described. [1][2][3][4] The aim of this paper is to evaluate the evolution of two patients who presented this injury diagnosed in acute and treated conservatively.…”

Section: Introductionmentioning

confidence: 99%

Nonsurgical treatment of deep transverse metacarpal ligament injuries

Saba¹,

M²,

E³

et al. 2022

MOJOR

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The deep transverse metacarpal ligament (DTML) is a structure that extends between the head of the second to fifth metacarpal to maintain the stability of the transverse metacarpal arch. Injuries of this ligament due to blunt trauma produce DTML injury and present with pain, decreased grip strength, deflection and diastasis of the affected fingers. Several surgical techniques for its reconstruction have been described. However, we evaluated the evolution of two patients who presented this injury diagnosed in acute and treated conservatively. Immobilization with forearm plaster in the intrinsic plus position and syndactyly to the adjacent finger was performed for 4 weeks. At one year of follow-up, they presented no pain (VAS 0/10) and showed hand function with comparable mobility to the contralateral hand and no diastasis between the fingers. We consider that in the face of DTML lesions evaluated in the acute period, diagnosis through clinical and radiological evaluation, as well as nonsurgical treatment, are usually sufficient.

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“…Ueba (1981) describes the use of the A1 pulleys to reconstruct the DTML in cleft hand reconstruction. This technique has also been used following trauma (Josty et al, 2006). Lee et al (2003) used a loop of palmaris longus tendon anchored through bony tunnels to reconstruct the DTMLs and the temporary use of transverse K-wires to support this reconstruction.…”

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confidence: 99%

A technique to reconstruct the deep transverse metacarpal ligament

Harley

Bain

Fleming

2012

J Hand Surg Eur Vol

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extension of the digit. The operation usually takes less than 1 min (not including anaesthesia).A total of 86 trigger fingers or thumbs (67 thumbs, 1 index finger, 10 middle fingers, 6 ring fingers, and 2 little fingers) in 70 patients were treated using this method between March 2005 and August 2010. Of the 70 patients, 56 had a single trigger digit, 13 had 2 trigger digits, and 1 had 4 trigger digits. Eighty-three digits (97%) were completely released during the first procedure, two digits required two procedures, and one digit required open release. Therefore, eventually 85 of 86 digits (99%) obtained a satisfactory result using our minimally invasive needle-knife. There were no injuries to the flexor tendons, common palmar digital arteries and nerves, or the superficial palmar arch during any of the procedures. Additionally, none of the patients suffered from loss of finger flexion or flexor bowstring following the procedure. The average cost was only €39 (£32; $50 US) per patient.The minimally invasive needle-knife overcomes the disadvantages of previously reported knives, such as difficulty in dividing a thickened pulley, and the requirement for inserting the tip of the knife into the A1 pulley (Chung et al., 2006; Ha et al., 2001).

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Reconstruction of Disruptions of the Deep Transverse Metacarpal Ligament of the Ring Finger Using the A1 Pulleys

Abstract: There is little information in the literature regarding the clinical features, investigation, diagnosis and treatment of closed rupture of the deep transverse metacarpal ligament. We demonstrate a case with previously undescribed features and describe the surgical management.

Cited by 6 publications

References 5 publications

Lipoblastoma of the Hand Treated With Excision and Ligament Reconstruction: A Case Report

Lipoblastoma of the Hand Treated With Excision and Ligament Reconstruction: A Case Report

Nonsurgical treatment of deep transverse metacarpal ligament injuries

A technique to reconstruct the deep transverse metacarpal ligament

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